title: Intramyocardial autologous cell engraftment in patients with ischaemic heart failure: a meta-analysis of randomised controlled trials.
abstract: BACKGROUND
  Intramyocardial cellular delivery provides a promising therapeutic strategy for ischaemic cardiac dysfunction. However, individual studies have reported controversial results.
  
  
  METHODS
  Relevant trials were identified by systematic search of MEDLINE, EMBASE, the Cochrane database, and CINAH database. Studies, which applied randomised design and compared intramyocardial cell injection with placebo or optimal medical therapy in patients with chronic ischaemic heart failure, were eligible.
  
  
  RESULTS
  A total of 210 participants in five randomised controlled trials were included. The pooled analyses showed that cell therapy did not significantly improve left ventricular ejection fraction compared with the control (95% CI -0.35 to 0.31, p=0.91). Nevertheless, cell therapy provided a benefit in increasing 6-min walk distance (95% CI 21.09 m-142.62 m, p=0.008), improving MLHF score (95% CI -25.21 to -3.55, p=0.009), and lowering the incidence of NYHA functional class deterioration (95% CI 0.05-0.76, p=0.02). However, the novel procedure did not result in a significant reduction in all-cause mortality. Conversely, cell therapy did not significantly increase the risk of ventricular tachycardia or acute heart failure, however we were underpowered to evaluate these endpoints.
  
  
  CONCLUSIONS
  Intramyocardial cell therapy was feasible in treating patients with ischaemic heart failure.
authors.affiliation: Department of Cardiology, XiJing Hospital, Fourth Military Medical University, Xi'an ShanXi 710032, China. Electronic address: chengkang20091224@foxmail.com.
authors.forename: Kang
authors.initials: K
authors.lastname: Cheng
authors.forename: Feng
authors.initials: F
authors.lastname: Wu
authors.forename: Feng
authors.initials: F
authors.lastname: Cao
mesh_terms: D064592:Autografts; D064987:Cell- and Tissue-Based Therapy / Q000379:methods; D006333:Heart Failure / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D016239:MEDLINE; D017202:Myocardial Ischemia / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D009206:Myocardium; D016032:Randomized Controlled Trials as Topic; D033581:Stem Cell Transplantation; D013318:Stroke Volume
keywords: Bone marrow mononuclear cell; Heart failure; Ischaemic; Meta-analysis; Myoblast